Toussirot Éric, Bereau Matthieu
Clinical Investigation Center in Biotherapy, INSERM CIC-1431, University Hospital, Place St Jacques, 25000 Besancon, France.
Inflamm Allergy Drug Targets. 2015;14(2):94-8. doi: 10.2174/1871528114666160105113046.
Vaccines have been suspected of playing a role in inducing autoimmune disease (AID) for a long time. However, apart from certain specific vaccine strains and complications (such as the swine flu vaccine and Guillain-Barré syndrome in 1976, thrombocytopenia and the Measles-Mumps-Rubella vaccine), this role has not been established. In spite of this, many isolated cases or series of cases of arthritis, vasculitis, and central or peripheral nervous system symptoms following vaccination have been reported. These cases tend to be very infrequent and usually only the shortterm outcomes are described. This paper will examine the arguments for and against the relationship between vaccines and AID, bearing in mind that no association between the two has been clearly identified up to now. The role of adjuvants in vaccines has been described by other teams and in a more general syndrome (Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants). Thus, cases of AID triggered by vaccines are highly rare and raise questions about the interaction between vaccines and/or their adjuvants and the genetic context of autoimmune disease. These observations should therefore not undermine the benefits of vaccination.
长期以来，疫苗一直被怀疑在诱发自身免疫性疾病（AID）方面发挥作用。然而，除了某些特定的疫苗毒株和并发症（如1976年的猪流感疫苗与格林-巴利综合征、血小板减少症与麻疹-腮腺炎-风疹疫苗）外，这一作用尚未得到证实。尽管如此，已有许多接种疫苗后出现关节炎、血管炎以及中枢或周围神经系统症状的孤立病例或病例系列被报道。这些病例往往非常罕见，而且通常仅描述了短期结果。本文将审视支持和反对疫苗与自身免疫性疾病之间关系的论据，同时要记住，到目前为止，两者之间尚未明确确定存在关联。其他团队已在更广泛的综合征（佐剂诱导的自身免疫/自身炎症综合征）中描述了佐剂在疫苗中的作用。因此，由疫苗引发的自身免疫性疾病病例极为罕见，并引发了关于疫苗和/或其佐剂与自身免疫性疾病遗传背景之间相互作用的问题。因此，这些观察结果不应削弱疫苗接种的益处。
